EP1992293B1 - Medical gripping device - Google Patents
Medical gripping device Download PDFInfo
- Publication number
- EP1992293B1 EP1992293B1 EP08153533.8A EP08153533A EP1992293B1 EP 1992293 B1 EP1992293 B1 EP 1992293B1 EP 08153533 A EP08153533 A EP 08153533A EP 1992293 B1 EP1992293 B1 EP 1992293B1
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- EP
- European Patent Office
- Prior art keywords
- elements
- web
- gripping device
- shaft
- branches
- Prior art date
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2906—Multiple forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
Definitions
- the present invention relates to a medical gripping device having a plurality of branches, which are individually controllable and in particular a medical gripping device according to the preamble of patent claim 1.
- a flexible endoscope is inserted into natural openings of the body, such as the mouth and anus. Since in this surgical method no direct access to the tissue to be operated o.a. is possible, flexible endoscopic instruments must be used. In this case, gripping instruments are also used which, for example, can take tissue samples or with which tissue can be gripped and manipulated.
- a gripping device having a hollow flexible shaft, at the front end of which two branches are rotatably mounted.
- the two branches form a kind of mouth, which can open to the front end of the gripping device.
- a tension- and pressure-resistant rope is mounted via a lever arm.
- the two cables are connected to one end of a Bowden cable, which runs through the pick shaft and is connected at its other end with a handle. With the operation of the handle, the jaw located at the other end of the gripper can be opened and closed.
- the whole gripping device is introduced into the body through a working channel of an endoscope.
- a gripping device has a flexible shaft with a rigid web (or a rigid jaw part) at one end. At this rigid bridge an industry is hinged, which is movable by means of a Bowden cable. The Bowden cable runs in the flexible shaft and is connected to the other end of the gripping device with a handle. With the operation of the handle will the industry is open and closed. This gripping device can be inserted through a working channel of an endoscope.
- the gripping devices of the prior art have some disadvantages. In practice, it is often necessary to connect tissue parts together or to close openings in the tissue. It is necessary that the corresponding tissue parts or the opposite edge portions of the openings can be grasped and thus fixed. Otherwise, no controlled connection or controlled closure of the tissue is possible. For example, if a perforation can not be occluded, open access must often be made to avoid complications caused by, for example, entering germs.
- the gripping devices of the prior art have only one mouth each, it is inevitably necessary that at least two of these gripping devices are used.
- the DE-OS 198 33 600 A1 discloses a medical forceps having two independently movable jaws which cooperate to form two mouths with a central ridge fixed to a distal end of a shaft.
- the from the DE-OS 198 33 600 A1 known medical forceps corresponds in terms of their structural design substantially to the prior art described above, wherein the shaft is a rigid steel shaft, which, although a certain bending elasticity, but is actually to call rigid.
- push rods 64, 66 are provided within the shaft for actuation transmission, the rigidity of which is sufficient to transmit actuation thrust forces to the jaw members.
- a medical gripping device has a flexible shaft with a front and a rear end, a web consisting of at least one web element, which is attached to the front end of the shaft, at least two branches, which are hinged to the web and at least two flexible control mechanisms disposed in the shaft.
- each individual industry is movable relative to the web by means of its own control mechanism. That is, the gripper has at least two mouths that can be opened and closed independently. Thus, at least two tissue sections can be seized and fixed separately.
- the shaft of the gripping device is flexible, so that it generates the least possible restoring forces when it is deformed out of its original shape.
- the branches may have barbs or teeth, they may be profiled or flat, straight or arcuate.
- the web elements can be designed accordingly in such a way that, in interaction with the branches, they prevent slippage of the gripped fabric from the respective mouth.
- the sectors and web elements can also be designed in particular so that they do not hurt the gripped tissue.
- the web of the medical gripping device consists of at least two web elements, wherein at most one of the web elements is rigidly secured to the shaft and the remaining web elements are rotatably hinged to the front end of the shaft or the maximum of a rigid web member. That is, the web members are either all rotatable at the front end of the Shaft articulated or a web member is rigidly connected to the front end of the shaft and the remaining web elements are rotatably hinged to the front end of the shaft or to the one rigid web member. At least one element is arranged between or on the web elements such that the movable web elements can be moved by means of the element at least in one direction. In addition, each branch of the gripping device is rotatably articulated on a web element.
- At least one elastic element is arranged on the web elements such that it urges the web elements apart at their distal end.
- an elastic element may be provided which urges all web elements apart, or a plurality of elastic elements may be provided, each pushing apart two web elements.
- the at least one elastic element can be arranged, for example, in the respective mouth between the web elements and press the web elements apart. This is possible for example by pressure springs or rubber elements.
- the at least one elastic element can also be arranged outside the mouths and pull apart the web elements. This can be realized for example by an arcuate tension spring.
- an elastic element but can also take over a magnetic element this task, wherein the magnetic element may be contained in the web elements.
- another element such as a kind of microscopic air spring could be used.
- these elements can also be arranged between the web elements and the shaft of the gripping device.
- electric micromotors can regulate the distance between the web elements. This embodiment may soon find application due to the rapid development in the field.
- the web elements can also be designed completely different.
- the individual movable web elements may be formed of an elastic material such as spring steel. These web elements are then connected at the end which faces the shaft, so that the ends of the web elements opposite to these connected ends are separated from one another by their inherent elasticity.
- This training is particularly useful when the medical gripping device according to the invention is used in conjunction with an endoscope.
- the gripping device according to the invention is introduced through a working channel of the endoscope.
- the web elements whose front ends in one of the ways described above have a tendency to move away from each other, can do so without restriction, as long as the entire head of the gripping device according to the invention, which consists of the branches and the web elements, out of the working channel of the endoscope protrudes.
- the web elements rest on the sleeve and are in a further pulling the gripper into the sleeve to the axis of the gripper out deformed. It can also be moved or pushed the sleeve.
- the only important thing here is the relative movement of gripper to sleeve.
- the front ends of the web elements move away from each other again. In this way, the distance between the front ends of the web elements and thus the inner edges of the mouths can be adjusted from each other.
- the distance of the web elements can be adapted to the distance of the tissue parts to be gripped.
- the sleeve may also be part of an endoscope.
- control mechanisms each have a tension- and pressure-resistant transmission element.
- the at least two transmission elements run together in the shaft, each of these Transmission elements is connected to an industry at the front end of the shaft.
- control mechanisms each have a control device which is provided at the rear end of the shaft and is connected to the associated transmission element. Each transmission element transmits the output from the corresponding control device movement to the appropriate industry.
- the transmission elements according to the invention are Bowden cables and
- the control devices are gripping elements, the gripping elements being actuated to open the corresponding industry and released to close the corresponding industry.
- the gripping elements are for example designed so that each handle element consists of a U-shaped bracket made of metal and the gripping elements form a handle or are provided on a handle.
- one end of the stirrup is attached to the rear end of the shank of the gripping device, and one end is at the other end of the stirrup the corresponding Bowden cable mounted.
- the handle elements thus together form the handle.
- the end of the yoke to which the Bowden cable is attached is pushed towards the other end of the yoke, the Bowden cable is forced into the shank of the gripper.
- the opposite end of the Bowden cable is pushed out and the linear movement of the Bowden cable end is transmitted, for example via a mounted on the associated industry lever in a rotational movement of the industry. More specifically, the corresponding industry is rotated so that the respective mouth is opened when the handle is pressed, that is, the bracket is compressed.
- the end of the strap to which the Bowden cable is attached moves away from the end of the strap mounted on the shaft end by the elasticity of the strap.
- the Bowden cable is pulled a little way out of the shaft at the rear end of the shaft and pulled a little way into the shaft at the opposite end (the front end) of the shaft.
- the associated industry is rotated so that the corresponding mouth is closed.
- the Bowden cables do not adversely affect each other in the shaft.
- the control mechanisms do not adversely affect.
- the grip elements so that the opening of the mouths of the gripping devices is effected by the elasticity of the grip elements and the respective grip element is actuated in order to close the corresponding mouth.
- the control devices can also be designed so that no element is provided which returns the associated branch to its starting position when the control device is released. That is, the respective grip element remains in the last position set by the user.
- a locking device may be provided, so that the set position does not change accidentally.
- the gripping elements can be provided on a common handle.
- the operation of the respective industry can then, for example by a Turning the control device about the axis of the gripper or to another axis by an operation of a push button, etc. are made.
- the branches may be mechanically, electrically, magnetically, hydraulically or pneumatically connected to the control devices.
- the control devices may be constructed so that the branches are normally open or normally closed. It is also possible that only one control device is provided for several industries, wherein upon actuation of the control device first a first industry is actuated and then another sector is actuated. In this case, it is advantageous if the branches can be distinguished so that the sequence of actuation of the at least two branches can be predicted.
- the handle elements can also be provided individually or in groups on different handles. This is particularly useful if three or more branches are present on the gripping device. Then several people are required if the industries are to be operated simultaneously. This is easier to handle when the handle members are attached to multiple handles, so that the handle members are easily accessible to the appropriate user.
- the associated transmission elements can be extended beyond the rear end of the common shaft and run in individual shafts.
- the branches and / or the associated web elements are distinguishable.
- the associated control devices are distinguishable, with a clear assignment of the appropriate industry to the associated control device is possible. In this way, before actuation of a control device, it is certain which industry is being operated. In addition, it can be safely decided in this way which control device is to be actuated in order to open a certain mouth. Acting in the wrong industry can result in the loss of an already grasped piece of tissue, thereby significantly increasing the overall time of the operation. It For example, as a result of the frequent manipulation, the edge sections may fray in such a way that the closure of the opening can no longer be securely carried out. In this case, often an open access with all its adverse consequences must be made.
- the branches and / or web elements are distinguishable by their color, their shape and / or their material.
- symbols or grooves can be formed on the branches and / or the web elements, which are found again corresponding to the associated control devices.
- Engravings can also be provided. Colors are only useful for differentiation if the industries and / or web elements can be viewed with a color camera.
- the material may be drawn for distinction if, for example, it has a different surface finish, such as a different roughness, a different reflection or a different color.
- a different transparency of the material can also be used for differentiation. It is likely that plastics will be increasingly used for medical purposes in the future. These can be transparent under certain circumstances.
- the branches and / or the web elements have cut edges. With these cut edges, for example, tissue parts can be severed or it can be separated a seam.
- the branches and the web elements are arranged symmetrically and the branches are rotatable in the radial direction to the axis of the gripping device. This means that the branches and the web elements are distributed uniformly in the circumferential direction of the gripping device.
- the web elements are rotatable in the radial direction to the axis of the gripping device.
- the medical gripping device of the web and the branches can also be designed so that the bridge, for example, protrudes further forward than the branches.
- the individual web elements and the individual sectors can also be designed differently in length.
- Fig. 1 is a side view of a head of a medical gripping device according to a first embodiment of the present invention, both mouths are opened.
- Fig. 2 is a side view of the head of the medical gripping device according to the first embodiment, in which a mouth is open.
- Fig. 3 is a side view of a handle of the medical gripping device according to the first embodiment.
- Figs. 4A, 4B and 4C 13 are schematic representations of a head of a medical gripping device according to a fifth embodiment in various states.
- Figs. 5A, 5B and 5C 13 are schematic representations of a head of a medical gripping device according to a sixth embodiment in various states.
- Figs. 6A, 6B and 6C 12 are schematic representations of handles of a medical gripping device according to various embodiments.
- Figs. 7A and 7B are side views of a medical gripping device according to a second embodiment of the present invention, wherein in the Fig. 7A the mouths open and the bridge elements are spaced and in the Fig. 7B the mouths are closed and the web elements are compressed.
- the medical gripper (1) of the first embodiment has a flexible shaft (2) with a front end (3) and a rear end (14).
- the shaft (2) is designed as a pressure-resistant bending soft spiral.
- it has a web (4) consisting of a single web element which is fixed to the front end (3) of the shaft (2).
- Two branches (5, 6) are pivoted to the web (4).
- Parts of two flexible control mechanisms (7, 9, 8, 10) are arranged in the shank (2) and each individual branch (5, 6) is moved by means of its own control mechanism (7, 9, 8, 10) with respect to the web (4 ) movable.
- the control mechanism (8, 10) controllable and in the Fig.
- control mechanism (7, 9) is controllable by the control mechanism (7, 9).
- the control mechanisms (7, 9, 8, 10) each have a tensile and pressure-resistant transmission element (7, 8) which run together in the shaft (2).
- Each of these transmission elements (7, 8) is connected to a branch (5, 6) at the front end (3) of the shaft (2).
- the control mechanisms (7, 9, 8, 10) each have a control device (9, 10) provided at the rear end (14) of the shaft (2) and connected to the associated transmission element (7, 8)
- each transmission element (7, 8) transmits the movement output by the corresponding control device (9, 10) to the corresponding branch (5, 6).
- the transmission elements (7, 8) are Bowden cables and the control devices (9, 10) are gripping elements.
- the gripping elements (9, 10) are actuated to open the corresponding branch (5, 6), and they are released to close the corresponding branch (5, 6).
- the gripping elements (9, 10) are provided on a common handle (15).
- the sectors (5, 6) and / or the associated web element (4) are indistinguishable in this embodiment.
- a medical gripping device (1) according to this embodiment, even later grooves or engravings on the branches (5, 6) and / or the web element (4) and the associated handle elements (9, 10) are provided so that then one unique assignment of handle element (9, 10) to branch (5, 6) is possible.
- the engraving or groove may be provided for discrimination on both side surfaces of the land member 4, for example, a groove being provided on both side surfaces of the land member 4 it is closer to the branch (5), and the grip element (9) associated with the branch (5) is also provided with a groove.
- the branches (5, 6) and the one web element (4) are arranged symmetrically. That is to say, the longitudinal axis of one of the bar elements (4) is identical to the longitudinal axis of the medical gripping device (1), and the two branches (5, 6) are articulated diametrically opposite to the bar element (4).
- the sectors (5, 6) are also rotatable in the radial direction to the axis of the gripping device (1).
- These extensions or levers (5 ', 6') are designed so that they are located in a recess of the bar element (4) when the branches (5, 6) are closed.
- the diameter of the head (18) of the gripping device (1) can be kept very small in the closed state.
- the head (18) of the gripping device (1) designates the elements provided at the front end (3) of the gripping device (1).
- the Bowden cables (7, 8) are fastened by means of hinge mechanisms to the extensions (5 ', 6') of the branches (5, 6).
- the front end of the bar member (4) is somewhat thickened and the front ends of the branches (5, 6) are slightly bent and tapered towards the bar member (4) so as to engage the front end of the bar member (4) a corresponding depression is provided.
- the two sectors (5, 6) are the same size and articulated on the same axis on the web element (4).
- a handle (15) is formed, which consists essentially of the handle elements (9, 10).
- the gripping elements (9, 10) are pushed onto a thickening, which is provided at the rear end (14) of the shaft (2), and fixed by means of an internal thread member (13) on the shaft (2). From the threaded element (13) protrude the two Bowden cables (7, 8).
- the sleeves (11, 12) serve only to guide the Bowden cables (7, 8).
- the handle elements (9, 10) are designed as elastic U-shaped bracket made of metal.
- the Bowden cables (7, 8) are fixed, wherein the last portion of each Bowden cable (7, 8) is rigid and upon actuation of the grip element (9, 10) is inserted into the respective sleeve (11, 12).
- the mouths of the gripping device (1) are closed in the initial state and are opened by an actuation of the gripping elements (9, 10).
- FIGS Figs. 7A and 7B A second embodiment of the medical gripping device is described with reference to FIGS Figs. 7A and 7B described.
- the medical gripping device (1) of the second embodiment also has a flexible shaft (2) with a front end (3) and a rear end (14), a web (4) consisting of two web elements (4A, 4B), wherein the web elements (4A, 4B) are attached to the front end (3) of the shaft (2), two branches (5, 6) which are hinged to the web elements (4A, 4B) at the articulation points (51A, 61 B), and two flexible control mechanisms (7, 9, 8, 10) at least partially disposed in the shaft (2).
- the industry (5) is by the Control mechanism (7, 9) relative to the web element (4A) rotatable and the branch (6) is rotatable by the control mechanism (8, 10) relative to the web element (4B).
- the web (4) consists of two web elements (4A, 4B), wherein none of the web elements (4A, 4B) is rigidly secured to the shaft.
- a member (70) is disposed on the web members (4A, 4B) so that the web members (4A, 4B) can be rotated relative to each other about the hinge points (41A, 41B).
- the element (70) is an elastic element, that is to say a compression spring in this case.
- the compression spring (70) forces the distal ends (42A, 42B) of the web elements (4A, 4B) apart.
- the gripping device (1) is pulled a little way into a working channel (80) of an endoscope, the web elements (4A, 4B) will be moved by the movement and the abutment against the edge (81) of the working channel (80) pressed against each other and the compression spring (70) is also pressed together.
- the control mechanisms (7, 9, 8, 10) each have a tension and compression-resistant transmission element (7, 8) which run together in the shaft (2), wherein each of these transmission elements (7, 8) the front end (3) of the shaft (2) is connected to a branch (5, 6).
- the transmission element (7) is hinged at the attachment point (52) to the lever (5 ') of the branch (5) and the transmission element (8) at the attachment point (62) to the lever (6') of the industry ( 6) hinged.
- Each transmission element (7, 8) transmits the movement output by the corresponding control device (9, 10) to the corresponding branch (5, 6).
- the transmission elements (7, 8) are Bowden cables.
- the grip elements (9, 10) are identical in shape and function to the fact that they are identical to the grip elements (9, 10) of the first exemplary embodiment in that the grip element (9) has a groove. Also in the second embodiment, the grip elements (9, 10) on a handle (15) are provided.
- branches (5, 6) are distinguishable, wherein the branch (5) has on its outer side a similar groove as the grip element (9). Thus, it is recognizable to the user which grip element (9, 10) controls which branch (5, 6).
- the web elements (4A, 4B) are arranged symmetrically and the branches (5, 6) are in the radial direction to the axis of the gripping device (1) about the articulation points (51A, 61B). rotatable around.
- the web elements (4A, 4B) are rotatable about the pivot points (41A, 41B) in the radial direction to the axis of the gripping device (1).
- the gripping device (1) of the second embodiment With the gripping device (1) of the second embodiment, the same effects as with the gripping device (1) of the first embodiment can be obtained.
- the distance of the two mouths of the gripping device (1) can be adjusted when the gripping device (1) is used together with an endoscope.
- the head (18) of the gripping device (1) of the second embodiment can be pulled so far into the working channel (80) of the endoscope that the web elements (4A, 4B) at the front edge (81) of the working channel (80) of Abut endoscope and by this edge (81) pressed together.
- the pulling in of the head (18) of the gripping device (1) is achieved by pulling on the shaft (2) of the gripping device (1) at the other end of the working channel (80).
- the third embodiment differs from the first embodiment only by the structure of the handle (15).
- the handle (15) is attached to the rear end (14) of the shaft (2).
- the gripping elements (9, 10) each consist of two parts (9A, 9B, 10A, 10B), the parts (9A, 10A) being fixed to the rear end (14) of the shaft (2).
- the two handle element parts (9A, 9B) and (10A, 10B) are articulated. Between the handle element parts (9A, 9B) and (10A, 10B) is in each case a compression spring (31, 32) is provided.
- the remaining structure and function of the handle (15) of the third embodiment correspond to the first embodiment and will therefore not be explained again.
- a fourth embodiment of the gripping device according to the invention is described with reference to FIGS Fig. 6C described.
- the fourth embodiment differs from the first embodiment in the structure and function of the handle (15).
- the elastic strap (9, 10) of the first embodiment are not bent in a U-shape here but rather assume a C-shape.
- the brackets are deformed in an operation but unlike the first embodiment.
- the gripping elements (9, 10) Upon actuation of the gripping elements (9, 10), the rear ends (16, 17) of the stirrups (9, 10) move away from the shank (2) and the Bowden cables (7, 8) move somewhat out of the shank (FIG. 2) pulled out.
- the branches (5, 6) are opened in the initial state, in contrast to the first embodiment, and are closed upon actuation of the corresponding grip element (9, 10).
- spacer elements (33, 34) are provided between the brackets (9, 10) spacer elements (33, 34) are provided. These spacing elements (33, 34) prevent the rear end (16, 17) of the actuated gripping element (9, 10) from being in contact with the other gripping element (9, 10) or the one upon actuation of one of the gripping elements (9, 10) associated Bowden cable (7, 8) comes and thus the state or the operation of the other industry (5, 6) influenced.
- grip elements (9, 10) it is advantageous in practice to provide only one grip element (9, 10) on a handle (15).
- a fifth embodiment of the gripping device (1) is described with reference to FIGS FIGS. 4A to 4C and 6A described.
- the gripping device (1) has three web elements (101, 102, 103) and three branches (201, 202, 203).
- the handle (15) of the gripping device (1) has three control devices (301, 302, 303) which can be uniquely assigned to the branches (201, 202, 203).
- the Assignment in this embodiment by engraving on the peripheral surfaces of the branches (201, 202, 203) and the web elements (101, 102, 103).
- the Figs. 4A, 4B and 4C each show a section perpendicular to the longitudinal axis of the gripping device (1) through the head (18) of the gripping device (1). In the Fig.
- the web elements (101, 102, 103) abut each other and the mouths are all closed. This state corresponds, for example, to passing the gripping device (1) through a working channel of an endoscope.
- the jaws of the gripping device (1) are also closed, but the web elements (201, 202, 203) are spaced from each other.
- the web elements (101, 102, 103) are pressed apart in this embodiment by a rubber ball (204), which is held between the web elements (101, 102, 103) in designated recesses.
- the web elements (101, 102, 103) are spaced less from each other than in the Fig.
- the handle (15) of the gripping device (1) of the fifth embodiment has a base body (300) on which control devices (301, 302, 303) are mounted.
- the control devices (301, 302, 303) are designed as rotary elements which have on their peripheral side the engraving corresponding to the engraving of the respectively associated branch (201, 202, 203).
- the corresponding rotary element (301, 302, 303) is rotated about the main body (300).
- Mechanisms are arranged in the interior of the basic body (300), which converts a rotational movement of each rotary element (301, 302, 303) into a translational movement of the associated Bowden cable.
- rotary elements (301, 302, 303) may also be arranged in the interior of the base body (300) elastic elements, which automatically return the respective rotary member (301, 302, 303) to the starting position when the rotary member (301, 302, 303) is released.
- a movement of a rotary element (301, 302, 303) to the right in the view of Fig. 6A For example, it may open the respective industry (201, 202, 203), and an opposing movement may close the respective industry (201, 202, 203).
- this type of handle (15) it is easy to provide more than two control devices on a handle (15) so that they can be easily operated. If, in addition, elements which prevent an automatic movement of the rotary elements (301, 302, 303) are also provided on the rotary elements (301, 302, 303), the gripping device (1) can easily be controlled by a single person.
- the shape of the branches (205, 206, 207) differs from the fifth embodiment.
- the web elements (105, 106, 107) by a rubber band (208) pulled together.
- the web members (105, 106, 107) are formed to have electromagnetic means that urge the web members (105, 106, 107) apart when activated. The strength of the magnetic repulsion can be adjusted via the supplied current.
- the rubber band (208) has a predetermined elasticity. Therefore, via the set magnetic repulsion of the web elements (105, 106, 107), the distance between the web elements to each other can be adjusted.
- the transmission elements for the branches (205, 206, 207) of this embodiment are Bowden cables as in the previous embodiments.
- the electrical lines for the electromagnetic devices are housed in this embodiment in the jacket of the shaft (2) of the gripping device (1).
- the handle (15) of the gripping device (1) of this embodiment therefore has over that in the Fig. 6A represented handle (15) via yet another rotary member, by means of which the electric current for the electromagnetic devices can be adjusted.
- the sectors (205, 206, 207) of the sixth embodiment can also be actuated by means of miromotors.
- the handle (15) can then be designed such that it has four rotary elements, of which three rotary elements control the opening of the respective branch (205, 206, 207) and one rotary element controls the spacing of the web elements (105, 106, 107). controls.
- the rotary elements are then designed, for example, as a rotary potentiometer.
- the states may also be controlled by a computer.
- control devices offer electrical sliders.
- the distance between the web elements can be adjusted to each other by means of a Bowden cable.
- the Bowden cables are formed so that the Bowden cables to the handle elements are a bit longer than the Bowden cable sheathing.
- end elements At the end of the Bowden cables are attached end elements in the form of circular disks.
- the rear ends of the Bowden cable sheathing are provided with ring elements, wherein the Bowden cables are guided through the ring elements.
- each helical compression springs are arranged so that the Bowden cables extend along the axes of the coil springs and abut the coil springs each on a closing element and a ring member and press them apart.
- the gripping device (1) which is described in this description only for medical purposes, can be used, for example, in precision mechanics.
- each individual branch (5, 6) can be moved individually relative to the web (4) by means of its own control mechanism (7, 9, 8, 10).
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Abstract
Description
Die vorliegende Erfindung bezieht sich auf ein medizinisches Greifgerät mit mehreren Branchen, die einzeln steuerbar sind und insbesondere ein medizinisches Greifgerät gemäß dem Oberbegriff des Patentanspruchs 1.The present invention relates to a medical gripping device having a plurality of branches, which are individually controllable and in particular a medical gripping device according to the preamble of
Heutzutage ist der Einsatz der flexiblen Endoskopie ein gängiger Standard für die diagnostische und therapeutische Behandlung von Erkrankungen des Magen-Darm-Trakts. Dabei wird ein flexibles Endoskop in natürliche Öffnungen des Körpers eingeführt, wie zum Beilspiel Mund und Anus. Da bei dieser Operationsmethode kein direkter Zugriff auf das zu operierende Gewebe o.a. möglich ist, müssen flexible endoskopische Instrumente verwendet werden. Hierbei kommen auch Greifinstrumente zum Einsatz, die beispielsweise Gewebeproben entnehmen können oder womit Gewebe gegriffen und manipuliert werden kann.Today, the use of flexible endoscopy is a common standard for the diagnostic and therapeutic treatment of diseases of the gastrointestinal tract. A flexible endoscope is inserted into natural openings of the body, such as the mouth and anus. Since in this surgical method no direct access to the tissue to be operated o.a. is possible, flexible endoscopic instruments must be used. In this case, gripping instruments are also used which, for example, can take tissue samples or with which tissue can be gripped and manipulated.
Im Stand der Technik gibt es ein Greifgerät, das einen hohlen flexiblen Schaft besitzt, an dessen vorderem Ende zwei Branchen drehbar befestigt sind. Die beiden Branchen bilden eine Art Maul, das sich zu dem vorderen Ende des Greifgeräts öffnen kann. An dem hinteren Ende jeder Branche ist über einen Hebelarm ein zug- und druckfestes Seil montiert. Die beiden Seile sind mit einem Ende eines Bowdenzugs verbunden, der durch den holen Schaft läuft und an seinem anderen Ende mit einem Griff verbunden ist. Mit der Betätigung des Griffs kann das Maul, das sich an dem anderen Ende des Greifgeräts befindet, geöffnet und geschlossen werden. Das ganze Greifgerät wird durch einen Arbeitskanal eines Endoskops in den Körper eingeführt.In the prior art, there is a gripping device having a hollow flexible shaft, at the front end of which two branches are rotatably mounted. The two branches form a kind of mouth, which can open to the front end of the gripping device. At the rear end of each branch, a tension- and pressure-resistant rope is mounted via a lever arm. The two cables are connected to one end of a Bowden cable, which runs through the pick shaft and is connected at its other end with a handle. With the operation of the handle, the jaw located at the other end of the gripper can be opened and closed. The whole gripping device is introduced into the body through a working channel of an endoscope.
Gemäß einem weiteren Instrument aus dem Stand der Technik besitzt ein Greifgerät einen flexiblen Schaft mit einem starren Steg (oder einem starren Maulteil) an einem Ende. An diesem starren Steg ist eine Branche angelenkt, die mittels eines Bowdenzugs bewegbar ist. Der Bowdenzug verläuft in dem flexiblen Schaft und ist an dem anderen Ende des Greifgeräts mit einem Griff verbunden. Mit der Betätigung des Griffs wird die Branche geöffnet und geschlossen. Dieses Greifgerät kann durch einen Arbeitskanal eines Endoskops eingeführt werden.According to another prior art instrument, a gripping device has a flexible shaft with a rigid web (or a rigid jaw part) at one end. At this rigid bridge an industry is hinged, which is movable by means of a Bowden cable. The Bowden cable runs in the flexible shaft and is connected to the other end of the gripping device with a handle. With the operation of the handle will the industry is open and closed. This gripping device can be inserted through a working channel of an endoscope.
Die Greifgeräte aus dem Stand der Technik besitzen allerdings einige Nachteile. In der Praxis ist es oft erforderlich, Gewebeteile miteinander zu verbinden oder Öffnungen im Gewebe zu verschließen. Dabei ist es erforderlich, dass die entsprechenden Gewebeteile oder die gegenüberliegenden Randabschnitte der Öffnungen gegriffen und somit fixiert werden können. Ansonsten ist keine kontrollierte Verbindung oder kein kontrollierter Verschluss des Gewebes möglich. Wenn zum Beispiel eine Perforation nicht verschlossen werden kann, muss oftmals ein offener Zugriff vorgenommen werden, um Komplikationen zu vermeiden, die beispielsweise durch eintretende Keime verursacht werden. Da aber die Greifgeräte aus dem Stand der Technik nur jeweils ein Maul besitzen, ist es zwangsläufig erforderlich, dass mindestens zwei dieser Greifgeräte zum Einsatz kommen. Dies ist aber im Hinblick auf den dann erforderlichen (zweiten Zugang) zweiten Arbeitskanal im Endoskop oder ein zusätzliches zweites Endoskop problematisch durch die Enge der natürlichen Körperöffnungen, wie beispielsweise Speiseröhre, Dünn- und Dickdarm. In jüngster Zeit wird an neuen Operationsmethoden, den so genannten NOTES (Natural Orifice Transluminal Endoscopy Surgery) geforscht, bei der versucht wird, ohne einen Hautschnitt in Körperhöhlen wie den Bauchraum zu gelangen, um dort zu operieren. Dabei werden die Zugänge mit Hilfe des flexiblen Instruments durch beispielsweise Magen, Dickdarm oder Vagina geschaffen. Diese Zugänge gilt es nach der Operation effektiv zu verschließen. Das gelingt jedoch nur wenn die entsprechenden Randabschnitte gegriffen und somit fixiert werden können.However, the gripping devices of the prior art have some disadvantages. In practice, it is often necessary to connect tissue parts together or to close openings in the tissue. It is necessary that the corresponding tissue parts or the opposite edge portions of the openings can be grasped and thus fixed. Otherwise, no controlled connection or controlled closure of the tissue is possible. For example, if a perforation can not be occluded, open access must often be made to avoid complications caused by, for example, entering germs. However, since the gripping devices of the prior art have only one mouth each, it is inevitably necessary that at least two of these gripping devices are used. However, this is problematic in view of the then required (second access) second working channel in the endoscope or an additional second endoscope by the narrowness of the natural body openings, such as esophagus, small and large intestine. Recently, research has been carried out into new surgical methods, the so-called NOTES (Natural Orifice Transluminal Endoscopy Surgery), in which an attempt is made to reach body cavities, such as the abdomen, without a skin incision in order to operate there. The accesses are created with the help of the flexible instrument by, for example, stomach, colon or vagina. These accesses must be closed effectively after the operation. However, this only succeeds if the corresponding edge sections can be grasped and thus fixed.
Die
Es ist daher eine Aufgabe der Erfindung, ein medizinisches Greifgerät vorzusehen, mit dem mindestens zwei Gewebeteile separat gegriffen und somit fixiert werden können, das eine höhere Funktionalität hat.It is therefore an object of the invention to provide a medical gripping device with which at least two tissue parts can be gripped and thus fixed separately, which has a higher functionality.
Die Aufgabe der vorliegenden Erfindung wird mit einem medizinischen Greifgerät gemäß dem Patentanspruch 1 gelöst. Weiter vorteilhafte Weiterbildungen des medizinischen Greifgeräts sind Gegenstand der Unteransprüche.The object of the present invention is achieved with a medical gripping device according to the
Gemäß einem ersten Aspekt der vorliegenden Erfindung besitzt ein medizinisches Greifgerät einen flexiblen Schaft mit einem vorderen und einem hinteren Ende, einen Steg bestehend aus mindestens einem Stegelement, der an dem vorderen Ende des Schafts befestigt ist, mindestens zwei Branchen, die an dem Steg angelenkt sind, und mindestens zwei flexible Steuermechanismen, die in dem Schaft angeordnet sind. Bei diesem medizinischen Greifgerät ist jede einzelne Branche mittels eines eigenen Steuermechanismus gegenüber dem Steg bewegbar. Das heißt, das Greifgerät besitzt mindestens zwei Mäuler, die unabhängig voneinander geöffnet und geschlossen werden können. Somit können mindestens zwei Gewebeabschnitte separat gegriffen und fixiert werden. Der Schaft des Greifgeräts ist flexibel, sodass er möglichst geringe Rückstellkräfte erzeugt, wenn er aus seiner Ausgangsform heraus verformt wird. An dem vorderen Ende des Schafts kann auch ein kleiner Vorsprung vorgesehen sein, an dem der Steg und die Branchen befestigt sein können. Die Branchen können zum Beispiel Widerhaken oder Zähne aufweisen, sie können profiliert oder flach, gerade oder bogenförmig sein. Die Stegelemente können entsprechend so ausgebildet sein, dass sie im Zusammenspiel mit den Branchen ein herausrutschen des gegriffenen Gewebes aus dem jeweiligen Maul verhindern. Die Branchen und Stegelemente können auch insbesondere so ausgebildet sein, dass sie das gegriffene Gewebe nicht verletzen.According to a first aspect of the present invention, a medical gripping device has a flexible shaft with a front and a rear end, a web consisting of at least one web element, which is attached to the front end of the shaft, at least two branches, which are hinged to the web and at least two flexible control mechanisms disposed in the shaft. In this medical gripping device, each individual industry is movable relative to the web by means of its own control mechanism. That is, the gripper has at least two mouths that can be opened and closed independently. Thus, at least two tissue sections can be seized and fixed separately. The shaft of the gripping device is flexible, so that it generates the least possible restoring forces when it is deformed out of its original shape. At the front end of the shaft may also be provided a small projection to which the web and the branches may be attached. For example, the branches may have barbs or teeth, they may be profiled or flat, straight or arcuate. The web elements can be designed accordingly in such a way that, in interaction with the branches, they prevent slippage of the gripped fabric from the respective mouth. The sectors and web elements can also be designed in particular so that they do not hurt the gripped tissue.
Gemäß einer vorteilhaften Ausführungsform besteht der Steg des medizinischen Greifgeräts aus mindestens zwei Stegelementen, wobei maximal eines der Stegelemente starr an dem Schaft befestigt ist und die restlichen Stegelemente drehbar an dem vorderen Ende des Schafts oder dem maximal einen starren Stegelement angelenkt sind. Das heißt, die Stegelemente sind entweder alle drehbar an dem vorderen Ende des Schafts angelenkt oder ein Stegelement ist starr mit dem vorderen Ende des Schafts verbunden und die restlichen Stegelemente sind drehbar an dem vorderen Ende des Schafts oder an dem einen starren Stegelement angelenkt. Zwischen oder an den Stegelementen ist mindestens ein Element so angeordnet, dass die beweglichen Stegelemente mit Hilfe des Elements zumindest in eine Richtung bewegt werden können. Darüber hinaus ist jede Branche des Greifgeräts an einem Stegelement drehbar angelenkt.According to an advantageous embodiment, the web of the medical gripping device consists of at least two web elements, wherein at most one of the web elements is rigidly secured to the shaft and the remaining web elements are rotatably hinged to the front end of the shaft or the maximum of a rigid web member. That is, the web members are either all rotatable at the front end of the Shaft articulated or a web member is rigidly connected to the front end of the shaft and the remaining web elements are rotatably hinged to the front end of the shaft or to the one rigid web member. At least one element is arranged between or on the web elements such that the movable web elements can be moved by means of the element at least in one direction. In addition, each branch of the gripping device is rotatably articulated on a web element.
Gemäß einer vorteilhaften Ausführungsform des medizinischen Greifgeräts ist mindestens ein elastisches Element so an den Stegelementen angeordnet, dass es die Stegelemente an ihrem körperfernen Ende auseinander drängt. Es kann entweder ein elastisches Element vorgesehen sein, das alle Stegelemente auseinander drängt, oder es können mehrere elastische Elemente vorgesehen sein, die jeweils zwei Stegelemente auseinander drängen. Das mindestens eine elastische Element kann beispielsweise in dem jeweiligen Maul zwischen den Stegelementen angeordnet sein und die Stegelemente auseinander drücken. Dies ist beispielsweise durch Druckfedem oder Gummielemente möglich. Im Gegensatz dazu kann das mindestens eine elastische Element aber auch außerhalb der Mäuler angeordnet sein und die Stegelemente auseinander ziehen. Dies kann zum Beispiel durch eine bogenförmige Zugfeder realisiert werden. Anstelle eines elastischen Elements kann aber auch ein magnetisches Element diese Aufgabe übernehmen, wobei das magnetische Element in den Stegelementen enthalten sein kann. Des Weiteren könnte auch ein anderes Element wie beispielsweise eine Art mikroskopische Luftdruckfeder verwendet werden. Diese Elemente können alternativ auch zwischen den Stegelementen und dem Schaft des Greifgeräts angeordnet sein.According to an advantageous embodiment of the medical gripping device, at least one elastic element is arranged on the web elements such that it urges the web elements apart at their distal end. Either an elastic element may be provided which urges all web elements apart, or a plurality of elastic elements may be provided, each pushing apart two web elements. The at least one elastic element can be arranged, for example, in the respective mouth between the web elements and press the web elements apart. This is possible for example by pressure springs or rubber elements. In contrast, the at least one elastic element can also be arranged outside the mouths and pull apart the web elements. This can be realized for example by an arcuate tension spring. Instead of an elastic element but can also take over a magnetic element this task, wherein the magnetic element may be contained in the web elements. Furthermore, another element such as a kind of microscopic air spring could be used. Alternatively, these elements can also be arranged between the web elements and the shaft of the gripping device.
Alternativ zu dem vorstehend beschriebenen Aufbau, können aber in Zukunft beispielsweise elektrische Mikromotoren den Abstand zwischen den Stegelementen regulieren. Diese Ausführungsform kann aufgrund der schnellen Entwicklung auf diesem Gebiet bereits bald Anwendung finden.As an alternative to the construction described above, however, in the future, for example, electric micromotors can regulate the distance between the web elements. This embodiment may soon find application due to the rapid development in the field.
Die Stegelemente können aber auch gänzlich anders ausgebildet sein. Zum Beispiel können die einzelnen beweglichen Stegelemente aus einem elastischen Material wie beispielsweise Federstahl ausgebildet sein. Diese Stegelemente werden dann an dem Ende, das dem Schaft zugewandt ist, so verbunden, dass sich die zu diesen verbundenen Enden entgegen gesetzten Enden der Stegelemente durch die ihnen eigene Elastizität voneinander entfernen.But the web elements can also be designed completely different. For example, the individual movable web elements may be formed of an elastic material such as spring steel. These web elements are then connected at the end which faces the shaft, so that the ends of the web elements opposite to these connected ends are separated from one another by their inherent elasticity.
Diese Ausbildung ist insbesondere dann sinnvoll, wenn das erfindungsgemäße medizinische Greifgerät im Zusammenspiel mit einem Endoskop verwendet wird. In diesem Fall wird das erfindungsgemäße Greifgerät durch einen Arbeitskanal des Endoskops eingeführt. Die Stegelemente, deren vordere Enden auf eine der zuvor beschriebenen Weisen das Bestreben haben, sich voneinander zu entfernen, können dies uneingeschränkt tun, so lange der gesamte Kopf des erfindungsgemäßen Greifgeräts, der aus den Branchen und den Stegelementen besteht, aus dem Arbeitskanal des Endoskops heraus ragt. Wenn aber der Kopf des Greifgeräts nun ein Stück weit in eine Hülse hinein gezogen wird, die sich an dem Ende des Endoskops befindet, liegen die Stegelemente an der Hülse an und werden bei einem weiteren Hineinziehen des Greifgeräts in die Hülse zu der Achse des Greifgeräts hin verformt. Es kann auch die Hülse bewegt bzw. aufgeschoben werden. Einzig wichtig hierbei ist die relative Bewegung von Greifgerät zu Hülse. Wenn der Kopf des Greifgeräts wieder vollständig aus der Hülse heraus geschoben wird, entfernen sich die vorderen Enden der Stegelemente wieder voneinander. Auf diese Weise kann der Abstand der vorderen Enden der Stegelemente und somit der inneren Ränder der Mäuler voneinander eingestellt werden. Somit kann der Abstand der Stegelemente dem Abstand der zu greifenden Gewebeteile angepasst werden. Die Hülse kann auch ein Teil eines Endoskops sein.This training is particularly useful when the medical gripping device according to the invention is used in conjunction with an endoscope. In this case, the gripping device according to the invention is introduced through a working channel of the endoscope. The web elements, whose front ends in one of the ways described above have a tendency to move away from each other, can do so without restriction, as long as the entire head of the gripping device according to the invention, which consists of the branches and the web elements, out of the working channel of the endoscope protrudes. However, if the head of the gripping device is now pulled into a sleeve into a sleeve, which is located at the end of the endoscope, the web elements rest on the sleeve and are in a further pulling the gripper into the sleeve to the axis of the gripper out deformed. It can also be moved or pushed the sleeve. The only important thing here is the relative movement of gripper to sleeve. When the head of the gripper is again pushed completely out of the sleeve, the front ends of the web elements move away from each other again. In this way, the distance between the front ends of the web elements and thus the inner edges of the mouths can be adjusted from each other. Thus, the distance of the web elements can be adapted to the distance of the tissue parts to be gripped. The sleeve may also be part of an endoscope.
Erfindungsgemäß besitzen die Steuermechanismen jeweils ein zug- und druckfestes Übertragungselement. Die mindestens zwei Übertragungselemente verlaufen gemeinsam in dem Schaft, wobei jedes dieser Übertragungselemente an dem vorderen Ende des Schafts mit einer Branche verbunden ist. Zudem besitzen die Steuermechanismen jeweils eine Steuervorrichtung, die an dem hinteren Ende des Schafts vorgesehen ist und mit dem zugehörigen Übertragungselement verbunden ist. Jedes Übertragungselement überträgt die von der entsprechenden Steuervorrichtung ausgegebene Bewegung an die entsprechende Branche.According to the invention, the control mechanisms each have a tension- and pressure-resistant transmission element. The at least two transmission elements run together in the shaft, each of these Transmission elements is connected to an industry at the front end of the shaft. In addition, the control mechanisms each have a control device which is provided at the rear end of the shaft and is connected to the associated transmission element. Each transmission element transmits the output from the corresponding control device movement to the appropriate industry.
Des Weiteren sind die Übertragungselemente erfindungsgemäß Bowdenzüge undFurthermore, the transmission elements according to the invention are Bowden cables and
die Steuervorrichtungen sind Griffelemente, wobei die Griffelemente betätigt werden, um die entsprechende Branche zu öffnen, und freigegeben werden, um die entsprechende Branche zu schließen. Die Griffelemente sind zum Beispiel so ausgebildet, dass jedes Griffelement aus einem U-förmigen Bügel aus Metall besteht und die Griffelemente einen Griff bilden oder an einem Griff vorgesehen sind. Ein Ende des Bügels ist beispielsweise an dem hinteren Ende des Schafts des Griffgeräts befestigt und an dem anderen Ende des Bügels ist ein Ende des entsprechenden Bowdenzugs montiert. Die Griffelemente bilden somit gemeinsam den Griff. Wenn das Ende des Bügels, an dem der Bowdenzug befestigt ist, zu dem anderen Ende des Bügels hin gedrückt wird, wird der Bowdenzug in den Schaft des Greifgeräts hinein gedrückt. Am anderen Ende des Schafts wird das entgegen gesetzte Ende des Bowdenzugs heraus gedrückt und die lineare Bewegung des Bowdenzugendes wird zum Beispiel über einen an der zugehörigen Branche angebrachten Hebel in eine Drehbewegung der Branche übertragen. Genauer gesagt wird die entsprechende Branche so gedreht, dass das jeweilige Maul geöffnet wird, wenn der Griff betätigt, das heißt der Bügel zusammengedrückt wird. Wenn der Griff freigegeben wird, bewegt sich das Ende des Bügels, an dem der Bowdenzug befestigt ist, durch die Elastizität des Bügels von dem an dem Schaftende montierten Ende des Bügels weg. Dadurch wird der Bowdenzug an dem hinteren Ende des Schafts ein Stück weit aus dem Schaft heraus gezogen und an dem entgegen gesetzten Ende (dem vorderen Ende) des Schafts ein Stück weit in den Schaft hinein gezogen. Durch diesen Vorgang wird die zugehörige Branche so gedreht, dass das entsprechende Maul geschlossen wird. Die Bowdenzüge beeinflussen sich gegenseitig in dem Schaft nicht nachteilig. Allgemein beeinflussen sich die Steuermechanismen nicht nachteilig. Es ist auch möglich, die Griffelemente so zu gestalten, dass das Öffnen der Mäuler der Greifgeräte durch die Elastizität der Griffelemente bewirkt wird und das jeweilige Griffelement betätigt wird, um das entsprechende Maul zu schließen. Die Steuervorrichtungen können aber auch so ausgebildet sein, dass kein Element vorgesehen ist, das die zugehörige Branche in ihre Ausgangsposition zurückführt, wenn die Steuervorrichtung freigegeben wird. Das heißt, das jeweilige Griffelement verbleibt in der zuletzt vom Nutzer eingestellten Position. Zudem kann beispielsweise eine Rasteinrichtung vorgesehen sein, sodass sich die eingestellte Position nicht versehentlich verändert.the control devices are gripping elements, the gripping elements being actuated to open the corresponding industry and released to close the corresponding industry. The gripping elements are for example designed so that each handle element consists of a U-shaped bracket made of metal and the gripping elements form a handle or are provided on a handle. For example, one end of the stirrup is attached to the rear end of the shank of the gripping device, and one end is at the other end of the stirrup the corresponding Bowden cable mounted. The handle elements thus together form the handle. When the end of the yoke to which the Bowden cable is attached is pushed towards the other end of the yoke, the Bowden cable is forced into the shank of the gripper. At the other end of the shaft, the opposite end of the Bowden cable is pushed out and the linear movement of the Bowden cable end is transmitted, for example via a mounted on the associated industry lever in a rotational movement of the industry. More specifically, the corresponding industry is rotated so that the respective mouth is opened when the handle is pressed, that is, the bracket is compressed. When the handle is released, the end of the strap to which the Bowden cable is attached moves away from the end of the strap mounted on the shaft end by the elasticity of the strap. As a result, the Bowden cable is pulled a little way out of the shaft at the rear end of the shaft and pulled a little way into the shaft at the opposite end (the front end) of the shaft. Through this process, the associated industry is rotated so that the corresponding mouth is closed. The Bowden cables do not adversely affect each other in the shaft. Generally, the control mechanisms do not adversely affect. It is also possible to make the grip elements so that the opening of the mouths of the gripping devices is effected by the elasticity of the grip elements and the respective grip element is actuated in order to close the corresponding mouth. However, the control devices can also be designed so that no element is provided which returns the associated branch to its starting position when the control device is released. That is, the respective grip element remains in the last position set by the user. In addition, for example, a locking device may be provided, so that the set position does not change accidentally.
Die Griffelemente können an einem gemeinsamen Griff vorgesehen sein. Die Betätigung der jeweiligen Branche kann dann zum Beispiel durch ein Drehen der Steuervorrichtung um die Achse des Greifgeräts oder um eine andere Achse durch eine Betätigung eines Druckknopfes etc. vorgenommen werden. Die Branchen können mechanisch, elektrisch, magnetisch, hydraulisch oder pneumatisch mit den Steuervorrichtungen verbunden sein. Die Steuervorrichtungen können so aufgebaut sein, dass die Branchen normalerweise geöffnet oder normalerweise geschlossen sind. Es ist auch möglich, dass für mehrere Branchen nur eine Steuervorrichtung vorgesehen ist, wobei bei der Betätigung der Steuervorrichtung zunächst eine erste Branche betätigt wird und anschließend eine weitere Branche betätigt wird. Hierbei ist es vorteilhaft, wenn die Branchen so unterscheidbar sind, dass die Reihenfolge der Betätigung der mindestens zwei Branchen vorhersehbar ist.The gripping elements can be provided on a common handle. The operation of the respective industry can then, for example by a Turning the control device about the axis of the gripper or to another axis by an operation of a push button, etc. are made. The branches may be mechanically, electrically, magnetically, hydraulically or pneumatically connected to the control devices. The control devices may be constructed so that the branches are normally open or normally closed. It is also possible that only one control device is provided for several industries, wherein upon actuation of the control device first a first industry is actuated and then another sector is actuated. In this case, it is advantageous if the branches can be distinguished so that the sequence of actuation of the at least two branches can be predicted.
Im Gegensatz dazu können die Griffelemente aber auch einzeln oder gruppenweise an verschiedenen Griffen vorgesehen sein. Dies ist insbesondere sinnvoll, wenn drei oder mehr Branchen an dem Greifgerät vorhanden sind. Dann sind mehrere Personen erforderlich, wenn die Branchen gleichzeitig betätigt werden sollen. Dies ist einfacher zu handhaben, wenn die Griffelemente an mehreren Griffen angebracht sind, so dass die Griffelemente für den entsprechenden Nutzer leicht zugänglich sind. Hierzu können die zugehörigen Übertragungselemente über das hintere Ende des gemeinsamen Schafts hinaus verlängert sein und in einzelnen Schäften verlaufen.In contrast, the handle elements can also be provided individually or in groups on different handles. This is particularly useful if three or more branches are present on the gripping device. Then several people are required if the industries are to be operated simultaneously. This is easier to handle when the handle members are attached to multiple handles, so that the handle members are easily accessible to the appropriate user. For this purpose, the associated transmission elements can be extended beyond the rear end of the common shaft and run in individual shafts.
Gemäß einer weiteren Ausführungsform des medizinischen Greifgeräts sind die Branchen und/oder die zugehörigen Stegelemente unterscheidbar. Außerdem sind die zugehörigen Steuervorrichtungen unterscheidbar, wobei eine eindeutige Zuordnung der entsprechenden Branche zu der zugehörigen Steuervorrichtung möglich ist. Auf diese Weise besteht vor einer Betätigung einer Steuervorrichtung Gewissheit darüber, welche Branche betätigt wird. Zudem kann auf diese Weise sicher entschieden werden, welche Steuervorrichtung betätigt werden soll, um ein bestimmtes Maul zu öffnen. Eine Betätigung der falschen Branche kann dazu führen, dass ein bereits gegriffenes Gewebestück verloren geht und dadurch die Gesamtzeit der Operation erheblich verlängert wird. Es kann auch beispielsweise zur Folge haben, dass die Randabschnitte durch das häufige manipulieren so ausfranst, sodass der Verschluss der Öffnung nicht mehr sicher durchgeführt werden kann. In diesem Fall muss oft ein offner Zugriff mit all seinen nachteiligen Folgen vorgenommen werden.According to a further embodiment of the medical gripping device, the branches and / or the associated web elements are distinguishable. In addition, the associated control devices are distinguishable, with a clear assignment of the appropriate industry to the associated control device is possible. In this way, before actuation of a control device, it is certain which industry is being operated. In addition, it can be safely decided in this way which control device is to be actuated in order to open a certain mouth. Acting in the wrong industry can result in the loss of an already grasped piece of tissue, thereby significantly increasing the overall time of the operation. It For example, as a result of the frequent manipulation, the edge sections may fray in such a way that the closure of the opening can no longer be securely carried out. In this case, often an open access with all its adverse consequences must be made.
Insbesondere sind die Branchen und/oder Stegelemente durch ihre Farbe, ihre Form und/oder ihr Material unterscheidbar. So können zum Beispiel Symbole oder Nuten an den Branchen und/oder den Stegelementen ausgebildet sein, die sich entsprechend an den zugehörigen Steuervorrichtungen wieder finden. Es können auch Gravuren vorgesehen sein. Farben eignen sich zur Unterscheidung nur dann, wenn die Branchen und/oder Stegelemente mit einer Farbkamera betrachtet werden können. Das Material kann zur Unterscheidung hergezogen werden, wenn es zum Beispiel eine unterschiedliche Oberflächenbeschaffenheit besitzt, wie zum Beispiel eine unterschiedliche Rauheit, eine unterschiedliche Reflexion oder eine unterschiedliche Farbe. Eine Unterschiedliche Durchsichtigkeit des Materials kann auch zur Unterscheidung herangezogen werden. Es ist wahrscheinlich, dass zukünftig vermehrt Kunststoffe für medizinische Zwecke verwendet werden. Diese können unter Umständen transparent sein.In particular, the branches and / or web elements are distinguishable by their color, their shape and / or their material. Thus, for example, symbols or grooves can be formed on the branches and / or the web elements, which are found again corresponding to the associated control devices. Engravings can also be provided. Colors are only useful for differentiation if the industries and / or web elements can be viewed with a color camera. The material may be drawn for distinction if, for example, it has a different surface finish, such as a different roughness, a different reflection or a different color. A different transparency of the material can also be used for differentiation. It is likely that plastics will be increasingly used for medical purposes in the future. These can be transparent under certain circumstances.
Gemäß einer weiteren vorteilhaften Ausbildung des medizinischen Greifgeräts weisen die Branchen und/oder die Stegelemente Schnittkanten auf. Mit diesen Schnittkanten können zum Beispiel Gewebeteile durchtrennt werden oder es kann eine Naht aufgetrennt werden.According to a further advantageous embodiment of the medical gripping device, the branches and / or the web elements have cut edges. With these cut edges, for example, tissue parts can be severed or it can be separated a seam.
Vorteilhafter Weise sind die Branchen und die Stegelemente symmetrisch angeordnet und die Branchen sind in radialer Richtung zu der Achse des Greifgeräts drehbar. Das heißt, dass die Branchen und die Stegelemente in Umfangsrichtung des Greifgeräts gleichmäßig verteilt angeordnet sind.Advantageously, the branches and the web elements are arranged symmetrically and the branches are rotatable in the radial direction to the axis of the gripping device. This means that the branches and the web elements are distributed uniformly in the circumferential direction of the gripping device.
Gemäß einer weiteren vorteilhaften Ausbildung des medizinischen Greifgeräts sind die Stegelemente in radialer Richtung zu der Achse des Greifgeräts drehbar. Alternativ dazu können sich die Branchen in tangentialer Richtung zu der Achse des Greifgeräts oder in einer anderen Richtung zu dieser bewegen.According to a further advantageous embodiment of the medical gripping device, the web elements are rotatable in the radial direction to the axis of the gripping device. Alternatively, the industries in tangential direction to the axis of the gripper or in a different direction to move to this.
Gemäß einer weiteren vorteilhaften Ausbildung des medizinischen Greifgeräts der Steg und die Branchen zu ihrem vorderen Ende hin gleich lang. Sie können aber auch so ausgebildet sein, dass der Steg zum Beispiel weiter nach vorne vorsteht als die Branchen. Die einzelnen Stegelemente und die einzelnen Branchen können aber auch untereinander unterschiedlich lang ausgebildet sein.According to a further advantageous embodiment of the medical gripping device of the web and the branches to their front end towards the same length. But they can also be designed so that the bridge, for example, protrudes further forward than the branches. However, the individual web elements and the individual sectors can also be designed differently in length.
Diese und weitere Aufgaben, Merkmale und Vorteile der vorliegenden Erfindung sind aus den Ausführungsbeispielen ersichtlich, die im Folgenden unter Bezugnahme auf die beigefügten Figuren detailliert beschrieben sind.These and other objects, features and advantages of the present invention will become apparent from the embodiments described in detail below with reference to the accompanying drawings.
(erstes Ausführungsbeispiel)(first embodiment)
Im Folgenden ist ein erstes Ausführungsbeispiel des medizinischen Greifgeräts der vorliegenden Erfindung unter Bezugnahme auf die
Das medizinische Greifgerät (1) des ersten Ausführungsbeispiels besitzt einen flexiblen Schaft (2) mit einem vorderen Ende (3) und einem hinteren Ende (14). Der Schaft (2) ist als eine druckfeste biegeweiche Spirale ausgebildet. Zudem besitzt es einen Steg (4) bestehend aus einem einzigen Stegelement, das an dem vorderen Ende (3) des Schafts (2) befestigt ist. Zwei Branchen (5, 6) sind an dem Steg (4) drehbar angelenkt. Teile von zwei flexiblen Steuermechanismen (7, 9, 8, 10) sind in dem Schaft (2) angeordnet und jede einzelne Branche (5, 6) ist mittels eines eigenen Steuermechanismus (7, 9, 8, 10) gegenüber dem Steg (4) bewegbar. In diesem Fall ist die in der
jedes Übertragungselement (7, 8) die von der entsprechenden Steuervorrichtung (9, 10) ausgegebene Bewegung an die entsprechende Branche (5, 6) überträgt.each transmission element (7, 8) transmits the movement output by the corresponding control device (9, 10) to the corresponding branch (5, 6).
Bei diesem Ausführungsbeispiel sind die Übertragungselemente (7, 8) Bowdenzüge und die Steuervorrichtungen (9, 10) sind Griffelemente. Die Griffelemente (9, 10) werden betätigt, um die entsprechende Branche (5, 6) zu öffnen, und sie werden freigegeben bzw. losgelassen, um die entsprechende Branche (5, 6) zu schließen. Die Griffelemente (9, 10) sind an einem gemeinsamen Griff (15) vorgesehen.In this embodiment, the transmission elements (7, 8) are Bowden cables and the control devices (9, 10) are gripping elements. The gripping elements (9, 10) are actuated to open the corresponding branch (5, 6), and they are released to close the corresponding branch (5, 6). The gripping elements (9, 10) are provided on a common handle (15).
Die Branchen (5, 6) und/oder das zugehörige Stegelement (4) sind bei diesem Ausführungsbeispiel nicht unterscheidbar. Allerdings können bei einem medizinischen Greifgerät (1) gemäß diesem Ausführungsbeispiel auch noch nachträglich Nuten oder Gravuren an den Branchen (5, 6) und/oder dem Stegelement (4) und den zugehörigen Griffelementen (9, 10) vorgesehen werden, so dass dann eine eindeutige Zuordnung von Griffelement (9, 10) zu Branche (5, 6) möglich ist. Da bei diesem Ausführungsbeispiel nur ein Stegelement (4) vorgesehen ist, kann die Gravur oder Nut zur Unterscheidung beispielsweise an beiden Seitenflächen des Stegelements (4) vorgesehen sein, wobei zum Beispiel eine Nut an beiden Seitenflächen des Stegelements (4) so vorgesehen wird, dass sie näher zu der Branche (5) ist, und das zu der Branche (5) zugehörige Griffelement (9) ebenfalls mit einer Nut versehen wird.The sectors (5, 6) and / or the associated web element (4) are indistinguishable in this embodiment. However, in a medical gripping device (1) according to this embodiment, even later grooves or engravings on the branches (5, 6) and / or the web element (4) and the associated handle elements (9, 10) are provided so that then one unique assignment of handle element (9, 10) to branch (5, 6) is possible. In this embodiment, since only one land member 4 is provided, the engraving or groove may be provided for discrimination on both side surfaces of the land member 4, for example, a groove being provided on both side surfaces of the land member 4 it is closer to the branch (5), and the grip element (9) associated with the branch (5) is also provided with a groove.
Die Branchen (5, 6) und das eine Stegelement (4) sind symmetrisch angeordnet. Das heißt, die Längsachse des eines Stegelements (4) ist mit der Längsachse des medizinischen Greifgeräts (1) identisch und die beiden Branchen (5, 6) sind diametral gegenüberliegend an dem Stegelement (4) angelenkt. Die Branchen (5, 6) sind zudem in radialer Richtung zu der Achse des Greifgeräts (1) drehbar.The branches (5, 6) and the one web element (4) are arranged symmetrically. That is to say, the longitudinal axis of one of the bar elements (4) is identical to the longitudinal axis of the medical gripping device (1), and the two branches (5, 6) are articulated diametrically opposite to the bar element (4). The sectors (5, 6) are also rotatable in the radial direction to the axis of the gripping device (1).
Wie dies in den
Die Bowdenzüge (7, 8) sind mittels Gelenkmechanismen an den Fortsätzen (5', 6') der Branchen (5, 6) befestigt. Das vordere Ende des Stegelements (4) ist etwas verdickt und die vorderen Enden der Branchen (5, 6) sind leicht zu dem Stegelement (4) hin so gebogen und verjüngt, dass sie in das vordere Ende des Stegelements (4) eingreifen, in dem eine entsprechende Vertiefung vorgesehen ist. Die beiden Branchen (5, 6) sind gleich groß und an derselben Achse an dem Stegelement (4) angelenkt.The Bowden cables (7, 8) are fastened by means of hinge mechanisms to the extensions (5 ', 6') of the branches (5, 6). The front end of the bar member (4) is somewhat thickened and the front ends of the branches (5, 6) are slightly bent and tapered towards the bar member (4) so as to engage the front end of the bar member (4) a corresponding depression is provided. The two sectors (5, 6) are the same size and articulated on the same axis on the web element (4).
An dem hinteren Ende (14) des Schafts (2) ist bei diesem Ausführungsbeispiel ein Griff (15) ausgebildet, der im Wesentlichen aus den Griffelementen (9, 10) besteht. Die Griffelemente (9, 10) sind auf eine Verdickung aufgeschoben, die an dem hinteren Ende (14) des Schafts (2) vorgesehen ist, und mittels eines Innengewindeelements (13) an dem Schaft (2) fixiert. Aus dem Gewindeelement (13) ragen die beiden Bowdenzüge (7, 8) hervor. Die Hülsen (11, 12) dienen lediglich der Führung der Bowdenzüge (7, 8). Die Griffelemente (9, 10) sind als elastische U-förmige Bügel aus Metall ausgebildet. An den freien Enden (16, 17) der Bügel (9, 10) sind die Bowdenzüge (7, 8) befestigt, wobei der letzte Abschnitt eines jeden Bowdenzugs (7, 8) steif ausgebildet ist und bei einer Betätigung des Griffelements (9, 10) in die jeweilige Hülse (11, 12) eingeführt wird. Bei diesem Ausführungsbeispiel sind die Mäuler des Greifgeräts (1) im Ausgangszustand geschlossen und werden durch eine Betätigung der Griffelemente (9, 10) geöffnet.At the rear end (14) of the shaft (2) in this embodiment, a handle (15) is formed, which consists essentially of the handle elements (9, 10). The gripping elements (9, 10) are pushed onto a thickening, which is provided at the rear end (14) of the shaft (2), and fixed by means of an internal thread member (13) on the shaft (2). From the threaded element (13) protrude the two Bowden cables (7, 8). The sleeves (11, 12) serve only to guide the Bowden cables (7, 8). The handle elements (9, 10) are designed as elastic U-shaped bracket made of metal. At the free ends (16, 17) of the bracket (9, 10), the Bowden cables (7, 8) are fixed, wherein the last portion of each Bowden cable (7, 8) is rigid and upon actuation of the grip element (9, 10) is inserted into the respective sleeve (11, 12). In this embodiment, the mouths of the gripping device (1) are closed in the initial state and are opened by an actuation of the gripping elements (9, 10).
(zweites Ausführungsbeispiel)(second embodiment)
Ein zweites Ausführungsbeispiel des medizinischen Greifgeräts ist unter Bezugnahme auf die
Das medizinische Greifgerät (1) des zweiten Ausführungsbeispiels besitzt auch einen flexiblen Schaft (2) mit einem vorderen Ende (3) und einem hinteren Ende (14), einen Steg (4) bestehend aus zwei Stegelementen (4A, 4B), wobei die Stegelemente (4A, 4B) an dem vorderen Ende (3) des Schafts (2) befestigt sind, zwei Branchen (5, 6), die an den Stegelementen (4A, 4B) an den Anlenkpunkten (51A, 61 B) angelenkt sind, und zwei flexible Steuermechanismen (7, 9, 8, 10), die zumindest teilweise in dem Schaft (2) angeordnet sind. Die Branche (5) ist durch den Steuermechanismus (7, 9) gegenüber dem Stegelement (4A) drehbar und die Branche (6) ist durch den Steuermechanismus (8, 10) gegenüber dem Stegelement (4B) drehbar. Bei diesem Ausführungsbeispiel besteht der Steg (4) aus zwei Stegelementen (4A, 4B), wobei keines der Stegelemente (4A, 4B) starr an dem Schaft befestigt ist. Ein Element (70) ist an den Stegelementen (4A, 4B) so angeordnet ist, dass die Stegelemente (4A, 4B) relativ zueinander um die Anlenkpunkte (41A, 41 B) herum gedreht werden können. Das Element (70) ist ein elastisches Element, das heißt in diesem Fall eine Druckfeder. Die Druckfeder (70) drängt die körperfernen Enden (42A, 42B) der Stegelemente (4A, 4B) auseinander. Wenn allerdings, wie dies in der Fig. 8B gezeigt ist, das Greifgerät (1) ein Stück weit in einen Arbeitskanal (80) eines Endoskops hinein gezogen wird, werden die Stegelemente (4A, 4B) durch die Bewegung und die Anlage an dem Rand (81) des Arbeitskanals (80) aufeinander zu gedrückt und die Druckfeder (70) wird auch zusammen gedrückt. Wie bei dem ersten Ausführungsbeispiel besitzen die Steuermechanismen (7, 9, 8, 10) jeweils ein zug- und druckfestes Übertragungselement (7, 8), die gemeinsam in dem Schaft (2) verlaufen, wobei jedes dieser Übertragungselemente (7, 8) an dem vorderen Ende (3) des Schafts (2) mit einer Branche (5, 6) verbunden ist. Genauer gesagt ist das Übertragungselement (7) an dem Befestigungspunkt (52) an dem Hebel (5') der Branche (5) gelenkig befestigt und das Übertragungselement (8) an dem Befestigungspunkt (62) an dem Hebel (6') der Branche (6) gelenkig befestigt. Jedes Übertragungselement (7, 8) überträgt die von der entsprechenden Steuervorrichtung (9, 10) ausgegebene Bewegung an die entsprechende Branche (5, 6).The medical gripping device (1) of the second embodiment also has a flexible shaft (2) with a front end (3) and a rear end (14), a web (4) consisting of two web elements (4A, 4B), wherein the web elements (4A, 4B) are attached to the front end (3) of the shaft (2), two branches (5, 6) which are hinged to the web elements (4A, 4B) at the articulation points (51A, 61 B), and two flexible control mechanisms (7, 9, 8, 10) at least partially disposed in the shaft (2). The industry (5) is by the Control mechanism (7, 9) relative to the web element (4A) rotatable and the branch (6) is rotatable by the control mechanism (8, 10) relative to the web element (4B). In this embodiment, the web (4) consists of two web elements (4A, 4B), wherein none of the web elements (4A, 4B) is rigidly secured to the shaft. A member (70) is disposed on the web members (4A, 4B) so that the web members (4A, 4B) can be rotated relative to each other about the hinge points (41A, 41B). The element (70) is an elastic element, that is to say a compression spring in this case. The compression spring (70) forces the distal ends (42A, 42B) of the web elements (4A, 4B) apart. However, if, as shown in Fig. 8B, the gripping device (1) is pulled a little way into a working channel (80) of an endoscope, the web elements (4A, 4B) will be moved by the movement and the abutment against the edge (81) of the working channel (80) pressed against each other and the compression spring (70) is also pressed together. As in the first embodiment, the control mechanisms (7, 9, 8, 10) each have a tension and compression-resistant transmission element (7, 8) which run together in the shaft (2), wherein each of these transmission elements (7, 8) the front end (3) of the shaft (2) is connected to a branch (5, 6). More specifically, the transmission element (7) is hinged at the attachment point (52) to the lever (5 ') of the branch (5) and the transmission element (8) at the attachment point (62) to the lever (6') of the industry ( 6) hinged. Each transmission element (7, 8) transmits the movement output by the corresponding control device (9, 10) to the corresponding branch (5, 6).
Bei dem zweiten Ausführungsbeispiel sind die Übertragungselemente (7, 8) Bowdenzüge. Die Griffelemente (9, 10) sind in Form und Funktion bis auf die Tatsache identisch zu den Griffelementen (9, 10) des ersten Ausführungsbeispiels, dass das Griffelement (9) eine Nut aufweist. Auch bei dem zweiten Ausführungsbeispiel sind die Griffelemente (9, 10) an einem Griff (15) vorgesehen.In the second embodiment, the transmission elements (7, 8) are Bowden cables. The grip elements (9, 10) are identical in shape and function to the fact that they are identical to the grip elements (9, 10) of the first exemplary embodiment in that the grip element (9) has a groove. Also in the second embodiment, the grip elements (9, 10) on a handle (15) are provided.
Die Branchen (5, 6) sind unterscheidbar, wobei die Branche (5) an ihrer Außenseite eine ähnliche Nut wie das Griffelement (9) aufweist. Somit ist für den Nutzer erkennbar, welches Griffelement (9, 10) welche Branche (5, 6) steuert.The branches (5, 6) are distinguishable, wherein the branch (5) has on its outer side a similar groove as the grip element (9). Thus, it is recognizable to the user which grip element (9, 10) controls which branch (5, 6).
Wie dies in den
Mit dem Greifgerät (1) des zweiten Ausführungsbeispiels können dieselben Effekte wie mit dem Greifgerät (1) des ersten Ausführungsbeispiels erzielt werden. Zudem kann durch die Ausbildung des Stegs (4) aus zwei Stegelementen (4A, 4B) der Abstand der beiden Mäuler des Greifgeräts (1) eingestellt werden, wenn das Greifgerät (1) zusammen mit einem Endoskop verwendet wird. Dann kann der Kopf (18) des Greifgeräts (1) des zweiten Ausführungsbeispiels so weit in den Arbeitskanal (80) des Endoskops hinein gezogen werden, dass die Stegelemente (4A, 4B) an dem vorderen Rand (81) des Arbeitskanals (80) des Endoskops anliegen und durch diesen Rand (81) zusammen gedrückt werden. Das Hineinziehen des Kopfs (18) des Greifgeräts (1) wird dadurch erreicht, dass man an dem anderen Ende des Arbeitskanals (80) an dem Schaft (2) des Greifgeräts (1) zieht.With the gripping device (1) of the second embodiment, the same effects as with the gripping device (1) of the first embodiment can be obtained. In addition, by the formation of the web (4) of two web elements (4A, 4B), the distance of the two mouths of the gripping device (1) can be adjusted when the gripping device (1) is used together with an endoscope. Then, the head (18) of the gripping device (1) of the second embodiment can be pulled so far into the working channel (80) of the endoscope that the web elements (4A, 4B) at the front edge (81) of the working channel (80) of Abut endoscope and by this edge (81) pressed together. The pulling in of the head (18) of the gripping device (1) is achieved by pulling on the shaft (2) of the gripping device (1) at the other end of the working channel (80).
(drittes Ausführungsbeispiel)(third embodiment)
Im Folgenden ist ein drittes Ausführungsbeispiel des Greifgeräts unter Bezugnahme auf die
(viertes Ausführungsbeispiel)(fourth embodiment)
Ein viertes Ausführungsbeispiel des erfindungsgemäßen Greifgeräts ist unter Bezugnahme auf die
(fünftes Ausführungsbeispiel)(fifth embodiment)
Ein fünftes Ausführungsbeispiel des Greifgeräts (1) ist unter Bezugnahme auf die
Der Griff (15) des Greifgeräts (1) des fünften Ausführungsbeispiels besitzt einen Grundkörper (300), an dem Steuervorrichtungen (301, 302, 303) angebracht sind. Die Steuervorrichtungen (301, 302, 303) sind als Drehelemente ausgebildet, die an ihrer Umfangsseite die Gravur aufweisen, die der Gravur der jeweils zugehörigen Branche (201, 202, 203) entspricht. Um eine Branche (201, 202, 203) zu bewegen, wird das entsprechende Drehelement (301, 302, 303) um den Grundkörper (300) gedreht. Im Inneren des Grundkörpers (300) sind Mechanismen angeordnet, die eine Drehbewegung eines jeden Drehelements (301, 302, 303) in eine translatorische Bewegung des zugehörigen Bowdenzugs umsetzt. An den Drehelementen (301, 302, 303) können im inneren des Grundkörpers (300) zudem elastische Elemente angeordnet sein, die das jeweilige Drehelement (301, 302, 303) wieder selbsttätig in die Ausgangsposition zurückführen, wenn das Drehelement (301, 302, 303) freigegeben wird. Eine Bewegung eines Drehelements (301, 302, 303) nach rechts in der Ansicht der
(sechstes Ausführungsbeispiel)(sixth embodiment)
Bei dem sechsten Ausführungsbeispiel des Greifgeräts (1), das in den
(weitere Ausführungsbeispiele)(further embodiments)
Gemäß einem weiteren Ausführungsbeispiel können die Branchen (205, 206, 207) des sechsten Ausführungsbeispiels auch mittels Miromotoren betätigt werden. Dann kann der Griff (15) zum Beispiel so ausgebildet sein, dass er vier Drehelemente besitzt, von denen drei Drehelemente die Öffnung der jeweiligen Branche (205, 206, 207) steuern und ein Drehelement den Abstand der Stegelemente (105, 106, 107) steuert. Die Drehelemente sind dann um Beispiel als Drehpotentiometer ausgebildet. Alternativ dazu können die Zustände auch mit Hilfe eins Computers gesteuert werden. Als weitere Alternative Steuervorrichtungen bieten sich elektrische Schieberegler an.According to a further embodiment, the sectors (205, 206, 207) of the sixth embodiment can also be actuated by means of miromotors. For example, the handle (15) can then be designed such that it has four rotary elements, of which three rotary elements control the opening of the respective branch (205, 206, 207) and one rotary element controls the spacing of the web elements (105, 106, 107). controls. The rotary elements are then designed, for example, as a rotary potentiometer. Alternatively, the states may also be controlled by a computer. As a further alternative control devices offer electrical sliders.
Gemäß einem weiteren Ausführungsbeispiel kann aber auch der Abstand der Stegelemente zueinander mittels eines Bowdenzugs eingestellt werden.According to a further embodiment, but also the distance between the web elements can be adjusted to each other by means of a Bowden cable.
Gemäß einem weiteren Ausführungsbeispiel der Erfindung sind die Bowdenzüge so ausgebildet, dass die Bowdenzugseile an den Griffelementen ein Stück weit länger als die Bowdenzugummantelungen sind. An dem Ende der Bowdenzüge sind Abschlusselemente in der Form von Kreisscheiben angebracht. Die hinteren Enden der Bowdenzugummantelungen sind mit Ringelementen versehen, wobei die Bowdenzüge durch die Ringelemente hindurch geführt sind. Zwischen den Ringelementen der Bowdenzugummantelungen und den Abschlusselementen der Bowdenzugseile sind jeweils Spiraldruckfedern so angeordnet, dass die Bowdenzugseile entlang der Achsen der Spiralfedern verlaufen und die Spiralfedern jeweils an einem Abschlusselement und einem Ringelement anliegen und diese auseinander drücken. Wenn nun das Abschlusselement durch den Nutzer zu dem Ringelement hin gedrückt wird, wird die dazwischen befindliche Spiralfeder gedrückt und die zugehörige Branche öffnet sich. Wenn das Abschlusselement freigegeben wird, führt die Spiralfeder das Abschlusselement in seine Ausgangsposition zurück und schließt die jeweilige Branche.According to a further embodiment of the invention, the Bowden cables are formed so that the Bowden cables to the handle elements are a bit longer than the Bowden cable sheathing. At the end of the Bowden cables are attached end elements in the form of circular disks. The rear ends of the Bowden cable sheathing are provided with ring elements, wherein the Bowden cables are guided through the ring elements. Between the ring elements of the Bowden cable sheathing and the end elements of the Bowden cables each helical compression springs are arranged so that the Bowden cables extend along the axes of the coil springs and abut the coil springs each on a closing element and a ring member and press them apart. Now, when the end member is pressed by the user to the ring member, the coil spring located therebetween is pressed and the associated branch opens. When the closure element is released, the coil spring returns the closure element to its original position and closes the respective industry.
Das Greifgerät (1), das in dieser Beschreibung nur für medizinische Zwecke beschrieben ist, kann beispielsweise auch in der Feinmechanik eingesetzt werden.The gripping device (1), which is described in this description only for medical purposes, can be used, for example, in precision mechanics.
Es ist das medizinisches Greifgerät (1) mit dem flexiblen Schaft (2), der das vordere Ende (13) und das hintere Ende (14) besitzt, dem Steg (4) bestehend aus mindestens einem Stegelement, wobei der Steg (4) an dem vorderen Ende (3) des Schafts (2) befestigt ist, den mindestens zwei Branchen (5, 6), die an dem Steg (4) angelenkt sind, und den mindestens zwei flexiblen Steuermechanismen (7, 9, 8,10) offenbart, die zumindest teilweise in dem Schaft (2) angeordnet sind. Bei dem erfindungsgemäßen medizinischen Greifgerät (1) ist jede einzelne Branche (5, 6) mittels eines eigenen Steuermechanismus (7, 9, 8, 10) gegenüber dem Steg (4) individuell bewegbar.It is the medical gripping device (1) with the flexible shaft (2) having the front end (13) and the rear end (14), the web (4) consisting of at least one web element, wherein the web (4) the front end (3) of the shaft (2) is fixed, the at least two branches (5, 6), which are hinged to the web (4), and the at least two flexible control mechanisms (7, 9, 8, 10) disclosed which are at least partially disposed in the shaft (2). In the medical gripping device (1) according to the invention, each individual branch (5, 6) can be moved individually relative to the web (4) by means of its own control mechanism (7, 9, 8, 10).
Claims (11)
- Medical gripping device (1) having a shaft (2) having a front end (13) and a rear end (14),
a web (4) comprising at least one web element, the web (4) being secured to the front end (3) of the shaft (2),
at least two branches (5, 6) which are articulated to the web (4) and
at least two flexible control mechanisms (7, 9, 8, 10) which are at least partially arranged in the shaft (2), each individual branch (5, 6) being able to be individually moved with respect to the web (4) by means of a separate control mechanism (7, 9, 8, 10) in order to form at least two mouths which can be opened and closed independently of each other, the control mechanisms (7, 9, 8, 10) each having a tension and pressure-resistant transmission element (7, 8) which extend together in the shaft (2), each of these transmission elements (7, 8) being connected to the front end (3) of the shaft (2) by means of a branch (5, 6) and each having a control device (9, 10) which is provided at the rear end (14) of the shaft (2), and being connected to the associated transmission element (7, 8),
each transmission element (7, 8) transmitting the movement transmitted by the corresponding control device (9, 10) to the corresponding branch (5, 6),
characterised in that the shaft (2) is flexible, in that the transmission elements (7, 8) are Bowden cables, and in that the control devices (9, 10) are gripping elements, the gripping elements (9, 10) being constructed in such a manner that activation of the gripping elements (9, 10) opens the corresponding branch (5, 6) and release of the gripping elements (9, 10) closes the corresponding branch (5, 6). - Medical gripping device (1) according to claim 1,
characterised in that
the web (4) comprises at least two web elements (4A, 4B), a maximum of one of the web elements (4A, 4B) being rigidly secured to the shaft (2) and the remaining web elements (4A, 4B) being pivotably articulated to the front end of the shaft (2) or the maximum one rigid web element (4A, 4B),
at least one actuation element (70) being arranged on the web elements (4A, 4B) and the web elements (4A, 4B) being able to be moved thereby relative to each other, a branch (5, 6) being rotatably articulated to a web element (4A, 4B), respectively. - Medical gripping device (1) according to claim 2,
characterised in that
the actuation element has at least one spring (70) which is arranged on the web elements (4A, 4B) in such a manner that it urges the web elements (4A, 4B) apart at the end (41A, 41B) thereof remote from the body. - Medical gripping device (1) according to claim 1,
characterised in that
the gripping elements (9, 10) are provided on a common handle (15). - Medical gripping device (1) according to claim 1,
characterised in that
the gripping elements (9, 10) are provided on individual handles. - Medical gripping device (1) according to any one of claims 1 to 5,
characterised in that
the branches (5, 6) and/or the associated web elements (4A, 4B) can be differentiated,
the associated control devices (9, 10) can be differentiated so that
a clear association of the corresponding branch (5, 6) with the associated control device (9, 10) is possible, respectively. - Medical gripping device (1) according to claim 6,
characterised in that
the branches (5, 6) and/or the web elements (4A, 4B) can be differentiated by their colour, their shape and/or their material. - Medical gripping device (1) according to any one of claims 1 to 7,
characterised in that
the branches (5, 6) and/or the web elements (4A, 4B) have cutting edges. - Medical gripping device (1) according to any one of claims 1 to 8,
characterised in that
the branches (5, 6) and the web elements (4A, 4B) are arranged symmetrically and the branches (5, 6) can be rotated in a radial direction relative to the axis of the gripping device (1). - Medical gripping device (1) according to any one of claims 1 to 9,
characterised in that
the web elements (4A, 4B) can be rotated in a radial direction relative to the axis of the gripping device (1). - Medical gripping device (1) according to any one of claims 1 to 10,
characterised in that
the web (4) and the branches (5, 6) are of the same length in the direction towards the front end thereof.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE200710000151 DE102007000151A1 (en) | 2007-03-14 | 2007-03-14 | Medical gripping device |
Publications (3)
Publication Number | Publication Date |
---|---|
EP1992293A2 EP1992293A2 (en) | 2008-11-19 |
EP1992293A3 EP1992293A3 (en) | 2009-05-20 |
EP1992293B1 true EP1992293B1 (en) | 2013-11-20 |
Family
ID=39687946
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP08153533.8A Active EP1992293B1 (en) | 2007-03-14 | 2008-03-28 | Medical gripping device |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP1992293B1 (en) |
DE (1) | DE102007000151A1 (en) |
ES (1) | ES2446526T3 (en) |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE102009001278A1 (en) | 2009-03-02 | 2010-09-09 | Tuebingen Scientific Medical Gmbh | Medical instrument, for surgery with minimal invasion or endoscopy, has a swing shaft or instrument housing at the distal end of a shaft in a two-part structure |
US10905411B2 (en) | 2017-11-03 | 2021-02-02 | Covidien Lp | Surgical suturing and grasping device |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6077287A (en) * | 1997-06-11 | 2000-06-20 | Endius Incorporated | Surgical instrument |
DE10013927A1 (en) * | 2000-03-21 | 2001-09-27 | Joachim Heinzl | Method and appliace for placing clips involve Bowden wire, pulley-cable, holder with two arms. |
DE20309775U1 (en) * | 2003-06-20 | 2003-10-02 | Aesculap Ag & Co Kg | Surgical instrument has force-limiting device located immediately adjacent to the proximal end of the Bowden cable operating link |
Family Cites Families (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5511564A (en) * | 1992-07-29 | 1996-04-30 | Valleylab Inc. | Laparoscopic stretching instrument and associated method |
AU1726999A (en) * | 1997-12-17 | 1999-07-05 | Surgical Insight, Inc. | Low profile endoscopic surgical instruments |
DE19833600A1 (en) * | 1998-07-25 | 2000-03-02 | Storz Karl Gmbh & Co Kg | Medical forceps with two independently movable jaw parts |
US6358268B1 (en) * | 2000-03-06 | 2002-03-19 | Robert B. Hunt | Surgical instrument |
US6443944B1 (en) * | 2000-05-19 | 2002-09-03 | Rajiv Doshi | Surgical devices comprising articulated members and methods for using the same |
US6632228B2 (en) * | 2000-08-23 | 2003-10-14 | Scimed Life System, Inc. | System, method, and apparatus for accurately deploying particular medical appliances at a target site |
US6440085B1 (en) * | 2001-06-12 | 2002-08-27 | Jacek Krzyzanowski | Method of assembling a non-metallic biopsy forceps jaw and a non-metallic biopsy forceps jaw |
-
2007
- 2007-03-14 DE DE200710000151 patent/DE102007000151A1/en not_active Withdrawn
-
2008
- 2008-03-28 ES ES08153533T patent/ES2446526T3/en active Active
- 2008-03-28 EP EP08153533.8A patent/EP1992293B1/en active Active
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6077287A (en) * | 1997-06-11 | 2000-06-20 | Endius Incorporated | Surgical instrument |
DE10013927A1 (en) * | 2000-03-21 | 2001-09-27 | Joachim Heinzl | Method and appliace for placing clips involve Bowden wire, pulley-cable, holder with two arms. |
DE20309775U1 (en) * | 2003-06-20 | 2003-10-02 | Aesculap Ag & Co Kg | Surgical instrument has force-limiting device located immediately adjacent to the proximal end of the Bowden cable operating link |
Also Published As
Publication number | Publication date |
---|---|
DE102007000151A1 (en) | 2008-09-18 |
EP1992293A3 (en) | 2009-05-20 |
EP1992293A2 (en) | 2008-11-19 |
ES2446526T3 (en) | 2014-03-10 |
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